Adult Dosing
Anorexia in AIDS patients
- 2.5 mg PO bid before lunch and supper
- In patients unable to tolerate, give 2.5 mg/day PO as a single dose in the evening or qhs
- Titrate the dose to 20 mg/day taken in divided doses, if clinically needed and in the absence of significant side effects
- Max: 20 mg/day
Note:
- Drug should be taken before lunch and/or supper
- Caution should be exercised while titrating the dose
Chemotherapy-induced nausea and vomiting
- Start dose 5 mg/m2 1-3 hrs prior to chemotherapy, then q2-4 hrs after chemotherapy for a total of 4-6 doses/day
- Increase the dose by increments of 2.5 mg/m2 to max 15 mg/m2/dose, if clinically indicated and in the absence of significant adverse effects
Note:
- Caution should be exercised while titrating the dose
Pediatric Dosing
- Safety and effectiveness for AIDS-related anorexia in pediatric patients have not been established
Chemotherapy-induced nausea and vomiting
- Start dose 5 mg/m2 1-3 hrs prior to chemotherapy, then q2-4 hrs after chemotherapy for a total of 4-6 doses/day
- Increase the dose by increments of 2.5 mg/m2 to max 15 mg/m2/dose, if clinically indicated and in the absence of significant adverse effects
Note:
- Therapy should be started at the lowest effective dosage and adjusted based on clinical response
- Use with caution when administered to children because of the psychoactive effects
- Caution should be exercised while titrating the dose
[Outline]
See Supplemental Patient Information
- Patients should be warned not to drive, operate machinery, or engage in hazardous tasks until they are able to tolerate the drug and perform such tasks safely
- Carefully evaluate the risk/benefit ratio of the drug in patients before administration
- Seizure and seizure-like activity have been reported with the use of this drug; exercise caution while administering to patients with a history of seizure disorder
- Use with caution in patients with cardiac disorders, history of substance abuse including alcohol abuse or dependence
Cautions: Use cautiously in
- Psychiatric disorders such as mania, depression, or schizophrenia
- Concomitant therapy with sedatives, hypnotics, or other psychoactive drugs
- Elderly patients
- Pregnant patients and nursing mothers
- Pediatric patients
Supplemental Patient Information
- Advise patients to avoid alcohol or other CNS depressants while on therapy
- Caution patients about the possible mood changes and other adverse behavioral effects of the drug so as to avoid panic if such events occur during therapy
- Instruct patients to remain under the supervision of a responsible adult during initial use and during dose modifications
Pregnancy Category:C
Breastfeeding: Data from marijuana smokers indicate that it is likely excreted into breastmilk and found in the urine of breastfed infants. There have been concerns regarding marijuana's possible effects on neurotransmitters, nervous system development and endocannabinoid-related functions. One long-term study found that daily use might retard the breastfed infant’s motor development, but not growth or intellectual development. There is no published data regarding the use of dronabinol as an antiemetic during breastfeeding. Hence an alternate drug may be preferred while nursing a newborn or preterm infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 5 March 2011). As per the manufacturer's data, dronabinol is not recommended in nursing women because in addition to secretion of HIV virus in breast milk, it is concentrated and secreted in breast milk, which is absorbed by the breastfed baby.
Pricing data from www.DrugStore.com in U.S.A.
- Marinol 5 MG CAPS [Bottle] (UNIMED)
90 mg = $1364.04
180 mg = $2720.07 - Dronabinol 5 MG CAPS [Bottle] (PAR)
60 mg = $679.93
180 mg = $1799.82 - Dronabinol 2.5 MG CAPS [Bottle] (WATSON LABS)
60 mg = $259.99
180 mg = $730.02 - Dronabinol 10 MG CAPS [Bottle] (WATSON LABS)
60 mg = $972.99
180 mg = $2638.03 - Marinol 2.5 MG CAPS [Bottle] (UNIMED)
30 mg = $238.99
60 mg = $441.97 - Marinol 10 MG CAPS [Bottle] (UNIMED)
30 mg = $867.55
60 mg = $1698.18
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
